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Return Address: x ,
' City Clerk's Office r I
City of Renton �
200 Mill Avenue South �-,
Renton,WA 98055-2189 �
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DEED(➢F'DEDICATION Property Tax Parcel No.: 855740-0005/855740-0010 ,�.,,a'
Project Fiie#�UA—�7-133 F Street Intersection S 22nd Place �
Reference Number(s)of Documents assigned or released: Additional reference numbers are on page ;
Grantor(s): Grantee(s):
1. Michael B.Jacobsen 1. City of Renton,a Municipal Corporation
LEGAL DESCRIPTION:
THAT PORTION OF LOTS 1 AND 2 OF TALBOT HEIGHTS ADDITION, ACCORDING TO TI-IE PLAT THEREOF w
RECORDED IN VO:,UME 48 OF PLATS,PAGE 80,KING COUNTY,WASHINGTON DESCRIBED AS FOLLOWS: ti
BEGINNING AT THE SOUTHWEST CORNER OF SAID LOT 1; THENCE SOUTH 88°31'26"EAST ALONG'fHE SOUTH �
LINE OF SAID L�,�T 1 TO THE SOUTHEAST CORNER THEREOF; THENCE NORTH 07°48'20"WEST ALONG THE EAST I
' LINE OF SAID LOT I, A DISTANCE OF 30.40'; THENCE NORTH 88°31'26" WEST A DISTANCE OF 52.09 FEET;
. T�;NCE NORTHWESTERLY ALONG A CURVE TO THE RIGHT,HAVING A RADIUS OF 88.00 FEET,AN ARC LENGTH
OF 138.23 FEET TO THE WEST LINE OF SAID LOT 2;THENCE SOUTH O1°28'34"WEST ALONG THE WEST LINE OF
� SAID LOTS 1 AND 2 A DISTANCE OF 118.00 FEET TO THE TRUE POINT OF BEGINNING
�/� SITUATED WITHIN THE SOU"I'I-IEAST QUARTER OF SECTION 19,TOWNSHIP 23 NORTH,RANGE 5 EAST,WM.IN THE
y� Cj'j'V QF RF\iTn?.I �
� The Grantor, for and in consideration of mutual benefits conveys, quitclaims, dedicates and donates to the
Q� Grantee(s)as named above,the above described real estate situated in the County of King,State of Washington.
� IN WITNESS WHEREOF,I have hereunto set my hand and seal the day and year as written above.
� ,�Awu�t y � 199�`
� Approved and Accepted By:
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� Grantor(s) Grantee(s): City of Renton ��Z�
By: By:
M r p�o Te ob Edwards
n.,.
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, �tyClerkM ri y J. Petersen
INDIVIDUAL FORM OF ACKNOWLEDGMENT
Notary Seal must be within box t�,�.'�s'�;'"`���4i,irir �
. State of Washington )ss ,,.�``��,�,1';•�.'��!r � !..� li
County of gie,r�e Kllif4 ) � � � '�;��
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I certify that I know or have satisfactory evidence t��:at,G11�'�.r�IG,pg.S.�F�j�
f•,—w .,,�
signed this instrument,on oa;.n�s;,�}e:':he was authc�rizPd I I
to execute the instrument and acknowledged it to be�,his:'t�.e'`:i���i::i:i`�'e ai:i �-: I
_ _�, .,� . .�.
voluntary act for the uses-�d purposes mentioned ii;+.1��r,�t�v�?;n��`�"p �
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Notary Publi n aiLdlfor the State of ashin on
Notary(Print) /tif l�}�l(�/✓T �LT��
My appointment expires:�� — �� ,r'}�-�O�
Dated: jpZ�,�—Fj�J
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��.�'.��$+@-�4 t3�.I�.�,�98 .E�O .UU
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State of (�:tL/�- • .
County of n
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On this�day of , 19 qg, _ �i�d� personally
appeared before me,
whose identity I verified on the basis of
�C who is personally known to me,
whose identity I verified on the oath/affirmation of
a credible witness,
to be the sign�r of the foregoing document, and he/she acknowledged that he/she signed it.
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_ �: �..- �;�.r�. y ,f;_ NotaryPublic
r,. �' `ptrs.,e ^' '� —
�° �M - My Commission expires: `� /� ��� ,
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,-lttribution Clause: 'lhisiflcknowledgment Cernficate is prepared for,and eacli�srnely be(ongs to.the accompnnying document ennded
� '� ,whrch consis[s of � page(si and is dated� (��//./�
" IJthls Certift te is appropriated to any docwnent other th.an the one descrrbec!herein,it shall be deemed null anJ��qt .
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Copynght 1995 by the NotazV L"dw[rISLtUt2 L'nauthonzed reproduchon ofany kind oCr}us fortn is smcdy prohib�ted. �
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Exhibit A
„ Legal Description
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FOR AREA TO BE DEDICATED
THAT PORTION OF LOTS 1 AND 2 OF TALBOT HEIGHTS ADDITION, ACCORDING TO THE
PLAT'THEREOF RECORDED IN VOLUME 48 OF PLATS,PAGE 80,KING COUNTY,
WASHINGTON,DESCRIBED AS FOLLOWS:
BEGINNING AT THE SOUTHWEST CORNER OF SAID LOT 1; ��
THENCE SOUTH 88°31'26"EAST ALONG TI-�SOUTH LINE OF SAID LOT 1 TO THE
SOUTHEAST CORNER THEREOF; �
T'HENCE NORTH 07°48'20"WEST ALONG'TI�EAST LINE OF SAID LOT 1 A DISTANCE OF
30.40 FEET;
THENCE NORTH 88°31'26" WEST A DISTANCE OF 52.09 FEET;
THENCE NORTHWESTERLY ALONG A CURVE TO THE RIGHT,HAVING A RADIUS OF 88.00
FEET,AN ARC LENGTH OF 138.23 FEET TO THE WEST LINE OF SAID LOT 2;
TI�NCE SOUTH O1°28'34"WEST ALONG TI�WEST LINE OF SAID LOTS 1 AND 2 A
DISTANCE OF 118.00 FEET TO THE TRUE POINT OF BEGI�NG.
SITUAT'ED WITHIN THE SOU'1'I�AST QUARTER OF SECTION 19,TOWNSHIP 23 IZTOR'I'H,
RANGE 5 EAST,W.M IN THE CITY OF RENTON.
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� Map Exhibit
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�- � s PLA T NO,l REN�l'C1N CODPERA TIVE
�:� COAC COMPANN ACRE TRACTS � f
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LOT3 /SKIVOWNASLOT "A" � � ,�, �40'� I
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`,� 5,938 sq.ft — S 8B3'!—��28 E — 234.OD' —� - -,
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N AREA Tp BE DEDICA TED I �
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� COAL C4MPANY ACRE TRACTS I � `
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Hformslxx��RMlAGREEQQ�1.]���\RTM Page 3 FORM 04 OOOIJbh
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PLEASE TYPE OR PRINT REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt when s[amped
PLE�ISE SEE REVERSE by cashier.
_ t CHAPTER 82.45 RCW-CHAPTER 458-61 WAC
4� For Use at County Treasurer's Office
�, (Use Form No. 84-0OO1B for Reporting Transfers of Controlling Interest of Entity Ownership to the Department of Revenue)
� THIS AFFIDAVIT WILL NOT BE ACCEYfED UNLESS ALL AREAS 1-7 ARE FULLY COMPLETED
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� Narrie �f�l�/ !'ri. a _ f � ..�.` � Name f. ! � f ,� :�t . r
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a a ��-f �}��' ��_i�`{ .fi�j a W , G�, t, : �f'� �.�{- � C �-� - <�.,-� :r� ...,
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W d� Street � �a Street �� r.% ,���'�!r %�:� 5
� City/State/Zip �_� ������- r �� .1��� � City/State/Zip �f r r�f� 'A✓�G�u�;'f r .:'t:S�
r� ADDR•ESS TO SEND ALL PROPERTY TAX RELATED CORRESPONDENCE ALL TAX PARCEL NUMBERS '`'£��NE�:'�'��5r3�;�iA�E:;:;;:;
cJ ASS�SSEt3 YhI:U�:iE'iTt1X:£}�EiS�1BT'
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St eet
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� LEGAL DESCRIPTION OF PROPERTY SITUATED IN ❑ UNINCORPORATED COUNTY Ifs OR IN CITY OF�.�e/?T of�±`
Street Address.(if property is improved): k�r'�y r.r C t i r< r: - tr.i,� �,�'
��� � 1� ��.� � ,�',:�'�` �'�i
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(� Is this property currently: YES NO , Descri tion of tan �ble ersonal ro ert if included in sale furniture
L�J .t � P g� P P P Y ( �
appliances, etc.) �
�Classified or designated as forest land? ❑ 0 �
� Chapter 84.33 RCW =- 1
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Classified as current use land (open space, farm ❑ ❑.�
and agricultural, or timber)? Chapter 84.34 RCW
Exempt from property tax as a nonprofit � � If exemption claimed, list WAC number and explanation.
organization? Chapter 84.36 RCW /
Seller's Exempt Reg. No. _____— ___ �'�'f1C No. (Sec/Sub) �-��V'��'��� �/1 t� �
Receiving special valuation as historic � 0 Explanation �`• :.<<. d•�- �.- 'x:'�.-t����o�'t�"t` r,Fc�r..>�-�
property? Chapter 8426 RCW ' f '
Property Type: � land only ❑ land with new building � "frr'�`�"�J"h'r�'°�`
❑ land with previously used building ❑ land with mobile home Type of Document ,�.r.�%r r, �i>,. �.�-«.-�
� timber only ❑ building only "
Date of Document l:r .� �` `�'��
Principal Use: O Apt. (4 + unit) ❑ residential ��,,
❑ timber ❑ a ricultural ❑ commercial/industrial Gross Sale Price $ ��'���
�`other �k�T� J��r�l+./ Personal Property (deduct) $
Ta�eable Sale Price $
� (1) NOTICE OF CONTINUANCE (RCW 84.33 or RCW 84.34) Excise Tax: State $
�
If the new owner(s)of land that is classified or designated as current use Local $ � �
or forest land wish to continue the classification or designation of such ' ,
land,the new owner(s)must sign below.If the new owner(s)do not desire Delinquent Interest: State $ �
to continue such classification or designation, all compensating or addi- Local $
tiona] tax calculated pursuant to RCW 84.33.120 and 140 or RCW,� Delinque�lt Penalty: State $ ^
84.34.108 shall be due and payable by the seller or transferor at the time
of sale.The county assessor must determine if the land transferred qualifies Total Due $ -r�^•'
to continue classification or designation and must so indicate below. THEKL' IS A$2.00 FEE FOR YKOCESSING THIS FORM IF NO TAX IS DUE
Signatures do not necessarily mean the land will remain in classification
or designation. If it no longer qualifies, it will be removed and the com- � AFFIDAV IT
pensaci❑g taxes will be applied. Alt new owners must sign. I certify under penalty of perjury under the laws of the state of
This land ❑does ❑does not qualify for continuance. Washington that the foregoing is true and correct(See back of this
form).
Date .4
DEPUTY ASSESSOR Signature of � ,
GrantorlAgent f ��� .� �%/��'r�'
(2) NOTICE OF COMPLIANCE (Chapter 84.26 RCW) y�� ' rf I
Name (print) !:: .,,F�� � f� ,..�5 � t' �t�r,...,. �: ��.,r�...,�
If the new owner(s)of property with special valuation as hisroric property � �> ,
wish to continue this special valuation the new owner(s)must sign below. Date & Place of Signin � ` ������ �r•, �-.v�
If the new owner(s)do not desire to continue such special valuation, all )f ///
additional tax calculated pursuant to Chapter 84.26 RCW, shall be due Signature of �-"'� ��i f��%�
and payable by the seller or transferor at the time of sale. Grantee/Agent �--�'`��� r': /! �_
(3) OWNER(S) SIGNATURE Name (print)�ayox Pro T�m Boh Edt�ktds
, � �- ^ ,
Date & Place of Signing • ' j � ' r✓
Perjury: Perjury is a class C felony which is punishable by imprisonment in a state correctional institution for a maximum term of not
m4ire than five years,or by a fine in an amount fixed by the court of not more than five thousand dollars($5,000.00),or by both imprisonment
anLl fine (RCW 9A.20.020 (1C)). _
REV 84 OOOIa(6-16-95) (PD 12-12-96) FOR TREASURER'S USE ONLY TAXPAYER I
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' �' i�����;�*�� f►if�i ;f��.� .t�;t, „�'3t� - .
TRANSFERS OF CONTROLLING INTEREST '
Does this transfer of real property reflect the transfer or acquisition of the controlling interest in iy
an entity with an interest in real property in this state? If the answer is yes, this transfer of controll- d
I ing interest must also be reported to the Department of Revenue within five days of the sale on �
Form No. 84-OOO1B.
(This is applicable only if SQ% or more of corporation stock, partnership, association, trust, or other
entity interest, is transferred or acquired within a 12 month period. Please refer to WAC 458-61-025, .
which appears on the reverse of Form No. 84-OOOIB)."
INTEREST AND PENALTIES
The Real Estate Excise Tax is due on the date of sale (date of the deed or contract of sale). A one-
percent per month interest is charged for delinquent tax payment. This is not charged if the tax is
paid within 30 days of the date of sale. A five, ten, and twenty percent penalty on the state taxes
is due from the seller if the tax is paid more than 30, 60, or 90 days past due. There is a 50 percent
' penalty for intentionally evading payment of the tax. _
AUDIT
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The Department of Revenue will conduct audits of the transactions and, if necessary, determine any �. _
underpayment of the tax. (WAC 458-61-130) '
�
To inquire about the availability of this form in an alternate format for the visually impaired or a
language other than English, call (360) 753-3217.
REV 84 OOOIA instr(6-16-95) (PD 12-12-96)
1
Exljibit A
Laga) Description
FQR AREA TO BE DEDICATED r�i�
THAT PORTION OF LOTS t AND 2 OF TALBOT NEiGHTS ADDITION, ACCORDING TO THE �
PLAT THEREOF RECtJRDED IN VOLUME 48 OF FLATS,PAGB 80,KING COtJNTY,
WASHINGT(}N,DESCRIBED AS FQLLOWS:
BEGINNING AT T'HE SOUTHWEST CORNER OF SAID LOT 1;
THENCE SOUTH 88°31'26"EAST ALONG'THE SOUTH LINE OF SAID LOT 1 TO THE
SOUTHEAST CORNER THEREOF;
THENCE NORTH 07°48'20" WEST ALONG THE EAST LINE OP SAID LC}T 1 A DISTANCE OF
3ii.�01�"EET;
THENCE NORTH 88°31'26" WEST A DISTANCE CIF 52.Q9 FEET;
THENCE NCIRTHWESTERLY AL(JNG A CURVE TO THE RIGHT,HAVING A ItADIUS OF 88.00
FEBT, AN A.RC LENGTH OF 13823 FEET TO THE WEST LINE OF SAID LQT 2;
TF�NCE SOUTH OI°28'34"WEST ALONG THE WEST LINE OF SAID LUTS I AND 2 A
DISTANCE 4F 118.Q0 FEET TQ TF3E TRLFE POINT OF BEGII�.'NING.
SITUATED WITHIN THE SOUTHEAST QUARTER OF SECTION 19,TOWNSHiP 23 NORTH,
RA,NGE S EAST,W.M. IN TI-IE CITY OF RENTON. �